The Tragedy of the Commons & Global Health

Response Blog Post #5

As Hardin describes in his “tragedy of the commons,” the commons, or shared, public access lands, are overgrazed because farmers have the ability to send their livestock onto the land at zero price. Mostly all farmers know that putting too many cows on a pasture will eventually destroy it by overgrazing. Yet, even with this knowledge in mind, they knowingly participate in overgrazing it anyways. Therefore, the public good is sacrificed for the individual good, because the cows cannot grow in a destroyed pasture. Although there initially seems to be an individual benefit of the ability to avoid needing to pay for land to allow cows to graze on, it doesn’t last long, because the lands become overgrazed and destroyed for cattle purposes. The individuals cannot escape the inevitability that the harm to the common is inherently a harm to each of them as well, and this is essentially what the social dilemma, the “tragedy of the commons” exemplifies.

This “tragedy of the commons” dilemma situation is largely demonstrated by global health and the misuse of antibiotics. Antibiotics are very important drugs to prevent the spread of disease, but they are supposed to only be used for bacterial infections. Yet, people use them for viral infections too. In doing so, the overexposure allows bacteria to build resistance and share resistant properties as they reproduce. If you take an antibiotic when you actually have a viral infection, the antibiotic is still attacking bacteria in your body – bacteria that are either beneficial or even those that are not causing the infection. This misdirected treatment can then promote antibiotic-resistant properties in harmless bacteria and allow bacterial strains to evolve and form resistance.

Although many perceive antibiotics as “wonder drugs” because they tend to work quickly and with little side effects, that is not a green light to use them 24/7. Patients widely pressure their doctors for antibiotic prescriptions because they want relief from their symptoms, no matter what the root cause of their illness. This common-held reasoning should be dispelled, because once the initial satisfaction of relief is gone, the problem is exacerbated in the form of a global public health concern.

It is nearing the end of 2015, health and medicine have been around for thousands of years, yet still, major biological injustices are being made every day. People are misusing antibiotics, and many who are doing so don’t understand the gravity of the situation. While widespread and often needless antibiotic use might cause a direct individual benefit, the cost of the widespread resistance is more distributed, and definitely acts as a larger hindrance to society and global health. The difficulty arises in that the solution to this problem, to ending antibiotic resistance, requires us to put society before the individual. Curtailing the rapid increase of resistance is only possible if some patients go untreated. This brings up the issue of the serious ethical concerns that follow. Undoubtedly, society would benefit from further restrictions in the number of times that each patient can take antibiotics in order to limit evolutionary selection for resistant strains. However, whether this will ever actually be enacted is a hard question to answer. One thing for certain is that difficult choices lie ahead, but hopefully the outcome of such choices will be progressive and not be harmful to society as a whole.

References:

Bell, Michael. 2014. "Antibiotic misuse: a global crisis." JAMA Internal Medicine 174, no.12: 1920-1921. MEDLINE with Full Text, EBSCOhost (accessed December 7, 2015).

"Consumer Health." Antibiotics: Misuse Puts You and Others at Risk. Accessed December 7, 2015.   http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/antibiotics/art-20045720

Foster, KR, and H Grundmann. n.d. "Do we need to put society first? The potential for tragedy in        antimicrobial resistance." Plos Medicine 3, no. 2: 177-180. Science Citation Index, EBSCOhost (accessed December 7, 2015).

Hollis, Aidan, and Peter Maybarduk. 2015. "Antibiotic Resistance Is a Tragedy of the Commons That Necessitates Global Cooperation." Journal Of Law, Medicine & Ethics 43, 33-37 5p. CINAHL Plus with Full Text, EBSCOhost (accessed December 7, 2015).